RESUMEN
The characteristic resistance of dorsopathies to conventional therapy explains the attention to new technologies that combine several therapeutic links and, in particular, ozone therapy. The study involved 90 patients under the age of 55 in the exacerbation phase of lumbar and sacrum dorsopathy with the leading vascular component. The patients were divided into three groups, in which basic medical and physical treatment was given. At the same time, ozone therapy was used the first two groups: the 1st group received standard ozone therapy, with a predominant selection of algic zones, the 2nd - according to the rules of biopuncture, affecting the complex of segmental, distant and "vascular" points. In the 3rd control group, the correction was limited to a standard therapeutic complex. The verification of the observed changes was carried out through clinical, psychological and electrophysiological analysis. As a result, both ozone therapy schemes (effective in 69% and 73% of observations respectively) were found to have a reliable advantage over the base complex, where 49% of patients demonstrated improvement. Differences within the ozone therapy groups themselves related to the achievement of a stable effect (in the 2nd group 2.6 days earlier) and the degree of reduction of vaso-reflex reactions (observed in 50% and 75% of observations respectively). Thus, by bringing in additional control methods, it has been proven that the implementation of ozone therapy in compliance with the rules of biopuncture ensures faster and more sustainable effects.
RESUMEN
Magnetic therapy (MT) is a non-drug method that improves the effectiveness of treatment of musculoskeletal pain, including:acute non-specific back pain (NBP). Objective of our study was to evaluate the results of complex treatment of patients with acute/subacute NBP at home using MT. The study group consisted of 339 patients with severe acute/subacute NBP. All patients received nonsteroidal anti-inflammatory drugs (NSAIDs). 166 patients (Group 1) received a course of MT (ALMAG+ device), 173 patients or a control group (Group 2) who did not receive MT. The dynamics of pain was significantly higher in group 1 than in group 2. So, the intensity of pain during movement (NRS) decreased from 7 [5;8] and 7 [5;8] to 0 [0;13] and 2 [1;3] after 1 month. (p<0.001). Significant differences between Groups 1 and 2 were observed in the dynamics of pain at rest and at night, overall health assessment (OHA), and sleep function and disorders. The average duration of NSAIDs use in Group 1 was 8.8±3.9, Group 2 - 11.8±5.7 days (p<0.001). The use of MT increases the effectiveness of treatment of acute/subacute NBP and reduces the need for NSAIDs use.
RESUMEN
Currently, diabetes mellitus (DM) is relevant problem, both for its prevalence and complications, including distal polyneuropathy (DPNP). At the same time, discussions continue on analgesic efficacy of transcutaneous electrical nerve stimulation (TENS) in DPNP. Aim of this study was to conduct a multi-faceted assessment of pain syndrome in these patients before and after TENS, taking into account levels of polyneuropathy, its severity and age of patients. The study was conducted in accordance with the research of the Federal State Budgetary Institution of the National Medical Research Center for Rehabilitation and Balneology of the Ministry of Health of the Russian Federation (CTR No. 121040100062-3) and with the permission of the Local Ethics Committee (IRB No. 2 dated 14.01.2021). The study included 75 patients with DM type II with DPNP, which are distributed into 3 groups of 25 people: Group 1a, patients received high-frequency TENS (HF); Group Ib, patients received low-frequency TENS (LF); as control, Group C received a standard method of pharmacological therapy without physiotherapy. Intensity of DPNP was evaluated before and after the course of treatment using a visual analog scale (VAS), the McGill Pain Questionnaire (MPQ), and a graphical linear analysis of pain on the neuropathic pain diagnostic questionnaire 4 (DN4) scale. TENS provides an analgesic effect that may exceed pharmacotherapy in terms of efficacy and safety. There was a 65.9% reduction in neuropathic pain according to VAS after a course of application, with the effects remaining up to 34% during the 6-month follow-up. HF TENS provided a higher significant analgesic effects than LF TENS, as it ensures the reduction of pain syndrome according to VAS by 25.8% (p <0.01), and total estimated characteristics - 35.5% (p <0.01), and touch - in at 58.1% (p = 0.001) and according to the scales of the MPQ (S) and DN4 - by 21% (p = 0.007). The observed differences in analgesic effects between HF TENS and LF TENS are based on analyses of pain in the immediate and long-term follow-up periods of type II DM patients with DPNP. These results, based on summation of the estimated parameters of the international pain scales support expectation of an expansion of the the use of analgesic TENS in aging patients suffering with DM of varying severity and extent of DPNP damage, a goal of great scientific and practical importance.
